Michigan Businesses Are Betting on DPC. The HSA Rule Change Made It Easy.

On January 1, the One Big Beautiful Bill’s Health Savings Account provision took effect, making Direct Primary Care memberships eligible for HSA spending. That was the legislation. The market response is the part still coming into view.

Crain’s Grand Rapids reported in October, ahead of the effective date, that Michigan direct primary care providers expected the HSA change to accelerate employer adoption, citing it as a catalyst that would give employers and employees a clearer financial path into membership-based medicine.

Who’s Growing

Exponential Health, a Grand Rapids-based DPC practice, now serves approximately 1,400 members across offices in Grand Rapids, Cascade Township, and Holland. CEO Roger Jansen told Crain’s that the HSA compatibility is “a real boost” for the practice. “It’s finally validating a membership approach to health care,” he said.

Plum Health DPC, founded by Dr. Paul Thomas in Detroit’s Corktown neighborhood, operates locations in Detroit, Royal Oak, Corunna, Lansing, and Van Buren. Its published rates are $95 per month for an individual, $180 for a member plus spouse or child, and $270 for a family. Thomas told Crain’s his team is now considering expansion into Grand Rapids, and that the legislative changes are accelerating adoption: “We are already seeing greater adoption. They will have more certainty that this is the right thing to do because of these legislative changes.”

Aloe Health, a new Grand Rapids-based company founded by Jeff Boore, has launched as a vetting service that matches employers with direct primary care practices. Boore sees the HSA change as “the opportunity where it’s coming into the mainstream” and believes it could fundamentally transform how primary care is delivered nationally.

The Market Numbers

A PitchBook report from October 2024 valued the U.S. direct primary care market at $24 billion and found that approximately 10% of companies with 1,000 or more employees currently contract with DPC providers. The researchers noted the market has “room to grow via new product expansion.”

Those numbers predate the HSA rule change. The law, signed in July 2025 and effective January 1, 2026, permits consumers to use HSA funds for DPC memberships up to $150 per month for individuals and $300 for families. Previously, the IRS classified DPC arrangements as disqualifying coverage that blocked HSA contributions entirely. That barrier is gone.

For employers already offering high-deductible health plans with family deductibles exceeding $5,000 annually, the math has shifted. Double-digit premium increases are pushing companies to look for alternatives that can run alongside catastrophic coverage. DPC fills that gap.

Why Michigan Matters

Michigan isn’t typically mentioned alongside DPC hotbeds like Colorado and Minnesota. But the state has several factors working in its favor: a manufacturing-heavy economy with self-funded employer plans looking to control costs, an established DPC pioneer in Dr. Thomas who has been building community partnerships with restaurants, school districts, and nonprofits for years, and now a regulatory environment that no longer penalizes employees for choosing membership medicine.

The fact that a matching service like Aloe Health can launch in Grand Rapids suggests the market has reached a density where employers need help navigating their options. That’s a signal of maturation.

What This Means

When we covered the HSA rule change in March, the question was whether the legislative win would translate into actual market movement. Michigan is an early indicator rather than an answer. The reporting captures providers who expected the change to land and were already seeing interest build ahead of it, not measured adoption since January. What it shows is that the people closest to the market were positioning for it.

If you’re running a DPC practice in a state with a strong employer base, the HSA compatibility isn’t just a talking point for your website. It’s actively changing how benefits consultants evaluate DPC. Companies that previously couldn’t justify the “double coverage” concern are now able to present DPC memberships as a tax-advantaged complement to their existing HDHP structure.

For physicians still considering the transition, the environment has shifted. The regulatory barrier that once made employers hesitate is gone. The matching services are launching. The market is being valued in the tens of billions. The question for the next twelve months isn’t whether employer-sponsored DPC will grow. It’s how fast.